New patient forms
New patients need to complete the following forms before being seen. Save time by printing and completing them at home, or arrive 30 minutes early and fill them out at home.
Short-term Disability forms
These forms are usually provided by your employer or insurance company. In an effort to streamline the process of completing the large volume of forms we receive daily, we are unable to complete short-term and long-term carrier-specific forms. Instead, we will attach to your form a computer-generated form, which will provide all the information that your insurance carrier is requesting. It may take up to five or seven business days to process your form. There are several ways you can get these forms to the administrative assistant for your doctor or mid-level provider:
• Fax the form(s) to (919) 863-6821
• Mail the form(s) to 3001 Edwards Mill Road, Raleigh, NC 27612
• Bring the form(s) to any office location
It would expedite completion of your form, if you would download the Short-Term Disability/FMLA Cover Sheet, complete it in full and sign it, then submit it with your form(s).
Consent for Release of Medical Information Short Term Disability Form